Objective: To observe the clinical efficacy of seggio combined with apatinib in the adjuvant treatment of primary liver cancer (PLC) after transcatheter arterial chemoembolization (TACE), and investigate the correlation between cell-free DNA (cfDNA) level and efficacy. Methods: A total of 60 patients with PLC after TACE in Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine from February 2014 to May 2015 were selected, including 30 patients treated with seggio combined with apatinib as a test group and 30 patients treated with seggio as a control group. After the treatment, the frequency of adverse reaction (ADR) was recorded, and the short-term efficacy of different groups was evaluated. At the same time, the differences in cfDNA levels of different groups and different efficacy were compared. PLC patients were further divided into a high expression group and a low expression group according to cfDNA expression level, and long-term follow-up of patients was performed to compare the difference in survival rate, median overall survival (MOS) time, and progression-free survival (PFS) time in different time periods. Cox univariate and multivariate analysis was used to analyse the factors affecting the survival rate of PLC patients after TACE. Results: The frequency ratio of ADR in the 2 groups was similar (P>0.05). The ORR of the test group was 53.33%, significantly higher than that of the control group (26.67%) (P<0.05). Long-term follow-up results showed that the MOS in the test group was longer than that in the control group. The 5-year survival rate of patients in the cfDNA high expression group was higher than that in the cfDNA low expression group (P<0.05), and the PFS was longer than that in the cfDNA low expression group (P<0.05). Cox multivariate analysis showed that Barcelona Clinic Liver Cancer (BCLC) stage and cfDNA concentration were independent risk factors that affected the prognosis of patients with advanced PLC. Conclusion: Seggio combined with apatinib adjuvant treatment of PLC patients after TACE is better than seggio monotherapy. ADR can be tolerated, which can improve the survival rate of patients, and the detection of cfDNA levels is effective for monitoring gefitinib. The efficacy have certain value.